Eligibility & enrollment
Am I eligible?
Here’s who qualifies for Medicare, when you can sign up, and how enrollment works.
Who qualifies
Premium-free Part A
At age 65
- You receive or are eligible to receive benefits from Social Security or the Railroad Retirement Board (RRB).
- Your spouse (living or deceased, including a divorced spouse) receives or is eligible to receive Social Security or RRB benefits.
- You or your spouse worked long enough in a government job where you paid Medicare taxes.
- You are the dependent parent of a fully insured deceased child.
Before age 65
- You’ve received Social Security Disability Insurance (SSDI) benefits for 24 months.
- You receive a disability pension from the Railroad Retirement Board (RRB) and meet certain conditions.
- You receive SSDI benefits and have Lou Gehrig’s disease (amyotrophic lateral sclerosis).
- You worked long enough in a government job where you paid Medicare taxes and have met the requirements of the SSDI program for 24 months.
- You are the child or surviving spouse (age 50 or older, including a divorced surviving spouse) of a worker who has worked long enough under Social Security or in a Medicare-covered government job and meet the requirements of the SSDI program.
Kidney failure before 65
You have permanent kidney failure (End-Stage Renal Disease) and receive maintenance dialysis or a kidney transplant, and one of the following applies:
- You’ve worked long enough under Social Security or the railroad retirement system.
- You’ve worked long enough in a Medicare-covered government job.
- You are the child or spouse (including a divorced spouse) of a worker (living or deceased) who has worked long enough under Social Security or the railroad retirement system, or in a Medicare-covered government job.
Part B
Anyone eligible for premium-free Part A can enroll in Part B by paying a monthly premium. Those with higher incomes may pay a higher Part B premium.
If you’re not eligible for premium-free Part A, you can still buy Part B without buying Part A if you’re 65 or older and are either a U.S. citizen or a lawfully admitted noncitizen who has lived in the United States for at least 5 years.
If you don’t enroll in Part B when you’re first eligible, you may have to pay a late enrollment penalty for as long as you have Part B.
When to sign up
Enrollment periods
Once you’re enrolled in Parts A and B, you can choose additional coverage from approved private insurers, such as Medicare Advantage, Medigap, or Part D.
Initial Enrollment Period
Your 7-month window starts 3 months before the month you turn 65, includes your birthday month, and ends 3 months after. For example, if you turn 65 in June, your window runs March 1 through September 30.
Initial Enrollment Period
Your window is based on when your Social Security or RRB disability benefits started. It begins in the 22nd month of benefits and ends in the 28th. For example, if benefits began in January 2025, your window runs October 2026 through April 2027.
Open Enrollment Period
Your yearly chance to review and change your coverage. You can:
- Join a Medicare Advantage (Part C) plan.
- Drop a Medicare Advantage plan and return to Original Medicare.
- Switch from one Medicare Advantage plan to another.
- Add or change a Part D plan if you have Original Medicare.
General Enrollment Period
If you missed your Initial Enrollment Period, you can sign up for Part A and/or Part B, or enroll in Part B if you opted out or dropped it before. Coverage starts the first day of the month after you sign up. You may pay a late enrollment penalty unless you qualify for a Special Enrollment Period.
Special Enrollment Period
In some situations, such as losing employer coverage, you may qualify to enroll or make changes outside the Initial and Open Enrollment Periods.
Automatic or manual
If you already receive Social Security or certain retirement benefits, you may be enrolled in Original Medicare automatically. Otherwise, you can sign up at ssa.gov/medicare/sign-up.
Frequently asked questions
Enrollment questions
Not sure which window applies to you? Book a call and I’ll help you figure it out.
Will I be automatically enrolled in Medicare?
You’ll be automatically enrolled in Part A and Part B if you’re turning 65 and already receive Social Security or Railroad Retirement Board (RRB) retirement benefits. You’ll also be enrolled automatically if you’re under 65 and have received disability benefits for 24 months. Your Medicare card arrives in the mail about three months before your 65th birthday or your 25th month of disability, with instructions for opting out of Part B if you want to.
What if I’m not receiving Social Security yet?
You won’t get a reminder letter, so you’ll need to sign up yourself. You can start three months before the month you turn 65 and have until three months after your birthday month. Missing this window could mean higher premiums.
How do I sign up?
It’s best to sign up as soon as you’re eligible to avoid penalties or gaps in coverage. You can apply online at ssa.gov/medicare/sign-up, or book a call and I’ll walk you through it.